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Carlos Alvarez, MD

General Surgery · San Jose

NPI 1982679239

Medicare standing
Clear
Enrolled, allowed to bill and order, not excluded
Plans that list them
5
2 carriers
Offices
2

Offices

2 locations · Surgicalists of CA PC · County of Santa Clara

Looking this up.

Plans that list them

5 plans · 2 carriers

A missing listing does not mean out of network. Directories change, and a listing does not cover every office. Call Dr. Alvarez’s office to confirm they take your plan. Ask about the office you use, its medical group, referrals and appointments.

5 of 5 plans

Plans whose provider directory lists this clinician
SCAN Balance (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
SCAN Classic (HMO)SCAN Health PlanListedOct 3, 2026
SCAN MyChoice (HMO)SCAN Health PlanListedOct 3, 2026
SCAN Strive (HMO C-SNP)SCAN Health PlanListedOct 3, 2026
DualConnect (HMO D-SNP)Santa Clara Family Health PlanListedSep 1, 2026

California Medical Board record

Licence G66787 · Current

Licensed to practise in California · since 2014 · expires 2027-09-30 · University of South Florida College of Medicine.

No disciplinary actions, convictions, malpractice judgments or citations in this record.

Original Medicare doctor bills

$60,853

Medicare paid this office $60,853 for 146 people.

This is what Medicare paid the clinician — not Medicare Advantage, and not the pharmacy.

Largest Original Medicare bills
New patient visit (45+ min)22$1,865$85
Removal of central venous tube with port or pump12$1,750$146
New patient visit (60+ min)13$1,622$125
New patient visit (30+ min)23$1,334$58
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes13$1,241$59
See all 9 services
Every Original Medicare service billed
New patient visit (45+ min)22$1,865$85
Removal of central venous tube with port or pump12$1,750$146
New patient visit (60+ min)13$1,622$125
New patient visit (30+ min)23$1,334$58
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes13$1,241$59
Short return visit (20+ min)24$1,238$48
Return visit (30+ min)14$1,065$76
New patient visit (15+ min)16$480$30
Short return visit11$276$25

Procedures Medicare counted

Procedure volume Medicare published
Colonoscopy1-10None
Hernia repair - groin (open)1-10None
Hernia repair (minimally invasive)1-10None
Removal of tissue14More than 65% of doctors who do this
Upper gastrointestinal (GI) endoscopy for acid reflux1-10None

Who their Medicare patients are

146 Original Medicare patients in 2024. Average age 73 · Under 65 10% · 85 and older 12% · Women 48% · Also on Medicaid 29% · Health risk score 1.44. At or below the middle of the specialty; the typical general surgery clinician is at 1.69.

Conditions among them: High blood pressure 68% · Diabetes 27% · Cancer 26% · COPD 24% · Coronary heart disease 23% · Chronic kidney disease 19% · Depression 18% · Atrial fibrillation 17% · Heart failure 14%.

The office billed $237,196, Medicare allowed $80,118 and paid $60,853; for 316 services of 77 kinds.

Original Medicare patients only. A risk score of 1.0 is the average Medicare patient; higher means sicker. Any count under 11 is hidden.

Year by year

Original Medicare by year
2024146316731.44$237,196$60,853
2023263545731.46$359,873$111,727
2022265652731.22$469,791$130,570
2021239542731.44$410,855$117,030
2020162371741.49$294,387$79,706
201864111732.27$80,713$24,678
2017160366742.05$258,944$81,197
2016158460751.83$315,470$89,487
2015115296721.71$181,912$56,587
201493273751.81$87,188$24,538
201369155731.50$114,372$34,514

Original Medicare only. A service billed for fewer than 11 people in a year is hidden, so the lines can add up to less than the year's total.

See the services billed each year

2023: 14 services

Original Medicare services billed in 2023
Removal of gallbladder using an endoscope14$6,970$498
New patient visit (60+ min)37$4,805$130
New patient visit (45+ min)52$4,713$91
Initial hospital care with moderate level of medical decision making at least 75 minutes23$3,040$127
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes22$2,307$82
New patient visit (30+ min)35$2,064$59
Return visit (30+ min)21$1,605$67
Long return visit (40+ min)14$1,382$92
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes19$1,324$58
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes12$1,241$103
Short return visit (20+ min)22$1,209$53
New patient visit (15+ min)23$841$37
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes12$511$39
Short return visit12$300$25

2022: 13 services

Original Medicare services billed in 2022
Initial hospital care with moderate level of medical decision making at least 75 minutes48$7,646$156
Removal of gallbladder using an endoscope14$7,432$531
Repair of groin hernia using an endoscope11$4,729$430
New patient visit (45+ min)46$4,403$96
New patient visit (60+ min)19$2,662$140
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes30$2,395$57
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes16$2,287$79
Return visit (30+ min)24$2,065$71
New patient visit (30+ min)27$1,644$61
Short return visit (20+ min)23$1,406$50
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes17$777$30
New patient visit (15+ min)23$740$32
Short return visit22$643$26

2021: 12 services

Original Medicare services billed in 2021
Initial hospital care with moderate level of medical decision making at least 75 minutes40$6,163$150
New patient visit (60+ min)27$3,871$143
Insertion of central venous tube with port (5 years or older)13$3,484$268
New patient visit (45+ min)32$3,385$106
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes21$2,338$58
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes22$2,269$84
New patient visit (30+ min)29$1,698$59
Return visit (30+ min)18$1,662$79
Short return visit (20+ min)23$1,272$55
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes24$1,000$31
New patient visit (15+ min)19$686$36
Short return visit13$413$28

2020: 9 services

Original Medicare services billed in 2020
Initial hospital care with moderate level of medical decision making at least 75 minutes36$6,594$169
Removal of gallbladder using an endoscope11$6,069$552
Insertion of central venous tube with port (5 years or older)20$5,524$276
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes25$2,429$61
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes13$2,005$87
New patient visit (45+ min)18$1,947$108
Return visit (30+ min)12$862$66
Telephone medical discussion with physician, 21-30 minutes13$861$66
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes15$624$33

2018: 1 service

Original Medicare services billed in 2018
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes11$694$33

2017: 11 services

Original Medicare services billed in 2017
Removal of gallbladder using an endoscope15$8,327$555
Initial hospital care with moderate level of medical decision making at least 75 minutes26$4,416$170
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes28$3,214$115
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes34$2,655$60
New patient visit (45+ min)13$1,792$138
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes15$1,572$87
Return visit (30+ min)12$1,246$83
Short return visit (20+ min)15$1,046$62
New patient visit (30+ min)14$987$71
Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes11$939$85
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes20$757$33

2016: 10 services

Original Medicare services billed in 2016
Removal of gallbladder using an endoscope11$6,032$548
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes35$3,901$111
Initial hospital care with moderate level of medical decision making at least 75 minutes17$2,903$161
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes32$2,691$60
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes50$2,587$33
Initial hospital care with straightforward or low level of medical decision making, per day at least 40 minutes27$2,286$85
New patient visit (45+ min)13$1,624$125
Return visit (30+ min)16$1,509$79
Short return visit (20+ min)20$1,283$53
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes12$1,123$86

2015: 7 services

Original Medicare services billed in 2015
Initial hospital care with moderate level of medical decision making at least 75 minutes19$3,386$169
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes24$2,747$114
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes23$1,867$60
Subsequent hospital care with moderate levelof medical decision making at least 50 minutes12$1,215$87
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes25$1,202$32
New patient visit (30+ min)13$1,093$84
Short return visit (20+ min)12$752$58

2014: 7 services

Original Medicare services billed in 2014
Initial hospital care with straightforward or low-level medical decision making at least 55 minutes16$1,836$115
Subsequent hospital care with moderate levelof medical decision making at least 35 minutes15$1,787$60
Removal of skin and tissue, 20.0 sq cm or less13$738$53
Short return visit21$716$21
Removal of tissue from wound, 20.0 sq cm or less20$636$19
Short return visit (20+ min)11$512$43
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes11$423$33

2013: 3 services

Original Medicare services billed in 2013
Initial hospital care with moderate level of medical decision making at least 75 minutes13$2,203$169
Short return visit (20+ min)13$722$56
Subsequent hospital care with straightforward or low level of medical decision making, per day at least 25 minutes14$617$32

Medicaid work

$55,927 in 2024

Medicaid paid $55,927 for 1,109 billed services this clinician did in 2024, up to 57 people in a month for one service.

Medicaid and CHIP claims where this clinician did the service, fee-for-service and managed care together. Any month with fewer than 11 patients is hidden, so small Medicaid practices undercount.

Largest Medicaid services in 2024
Clinic visit/encounter, all-inclusive303$50,134
New patient visit (30+ min)147$3,012
Short return visit (20+ min)187$1,839
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion26$698
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (List separately in addition to code for first lesion)23$244
Medication list documented in medical record (COA)157$0
Review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions, OTCs, herbal therapies and supplements) documented in the medical record (COA)121$0
BODY MASS INDEX DOCD145$0
Medicaid work by year
20241,109857$55,927
20231,473969$89,667
202268119$10,300
202185117$11,713
202048116$6,346
See the largest Medicaid services in earlier years

2023

Largest Medicaid services in 2023
Clinic visit/encounter, all-inclusive480$78,533
New patient visit (30+ min)290$6,097
Short return visit (20+ min)176$2,173
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions36$1,397
Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion33$1,187
OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES21$281
Medication list documented in medical record (COA)173$0
Review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions, OTCs, herbal therapies and supplements) documented in the medical record (COA)100$0
BODY MASS INDEX DOCD164$0

2022

Largest Medicaid services in 2022
Clinic visit/encounter, all-inclusive68$10,300

2021

Largest Medicaid services in 2021
Clinic visit/encounter, all-inclusive85$11,713

2020

Largest Medicaid services in 2020
Clinic visit/encounter, all-inclusive48$6,346

Drugs they prescribed that Part D paid

$2,644

Pharmacies billed $2,644 in 2024.

This is pharmacy cost, not the office bill, and not what patients paid.

Opioids were 22% of their Part D prescriptions (35 of 158) in 2024. At or below the middle of the specialty; the typical general surgery clinician is at 34%.

154 generic and fewer than 11 brand-name prescriptions · $2,644 in drug cost · 31 antibiotic prescriptions to 16 people.

Part D prescriptions only. The opioid rate is opioid prescriptions as a share of all this clinician's Part D prescriptions; surgeons and pain specialists run higher than others, so it is shown against the same specialty.

Largest Part D drug costs
Naloxone12$670$56
Celecoxib22$290$9
Oxycodone26$191$6

Year by year

Part D prescribing by year
20241584722% (35)None$2,644
20232598624% (61)None$11,281
20222077629% (59)None$3,686
20211346036% (48)None$3,045
2020543241% (22)None$1,604
20183622NoneNone$1,512
20171446024% (34)15%$4,713
20161375129% (39)13%$2,937
2015923930% (28)17%$2,237
2014802729% (23)29%$6,057
2013602437% (22)None$1,434

Part D prescriptions only. A drug prescribed to fewer than 11 people in a year is hidden.

See the drugs prescribed each year

2023: 6 drugs

Part D drugs prescribed in 2023
Naloxone15$1,115$74
Celecoxib46$805$17
Sulfamethoxazole-Trimethoprim19$230$12
Oxycodone51$191$4
Neomycin Sulfate15$94$6
Metronidazole16$33$2

2022: 2 drugs

Part D drugs prescribed in 2022
Celecoxib40$812$20
Oxycodone51$215$4

2021: 2 drugs

Part D drugs prescribed in 2021
Celecoxib23$397$17
Oxycodone44$127$3

2020: 1 drug

Part D drugs prescribed in 2020
Oxycodone16$52$3

2017: 3 drugs

Part D drugs prescribed in 2017
Celecoxib22$893$41
Quetiapine16$282$18
Acetaminophen-Codeine13$55$4

2016: 3 drugs

Part D drugs prescribed in 2016
Risperidone13$187$14
Mirtazapine13$140$11
Hydrocodone-Acetaminophen15$139$9

2015: 3 drugs

Part D drugs prescribed in 2015
Hydrocodone-Acetaminophen11$290$26
Mirtazapine13$187$14
Risperidone13$169$13

2014: 3 drugs

Part D drugs prescribed in 2014
Mirtazapine13$985$76
Risperidone13$170$13
Acetaminophen-Codeine12$91$8

Money from drug and device companies

$30 in 2024

Industry payments by year
202411None$30
202244None$213
202122None$38
202011None$21
201911None$89

Paid work is consulting, speaking, honoraria and royalties, as opposed to meals and travel.

A payment is not proof that care is biased.

Payments by company
Janssen PharmaceuticalsXarelto$30
1 payment
  • Meals for Xarelto · 2024-10-22 · $30
See the published payment
Every published payment
Janssen PharmaceuticalsMeals · 2024-10-22Xarelto$30
See earlier years (2022, 2021, 2020, 2019)

2022: $213

Payments by company in 2022
Endogastric SolutionsEsophyx$125
1 payment
  • Meals for Esophyx · 2022-10-18 · $125
Avanos MedicalOn-Q* Pump and Accessories$40
1 payment
  • Meals for On-Q* Pump and Accessories · 2022-08-24 · $40
Scilex PharmaceuticalsNone$24
1 payment
  • Meals · 2022-02-21 · $24
Heron TherapeuticsZynrelef$24
1 payment
  • Meals for Zynrelef · 2022-11-30 · $24

2021: $38

Payments by company in 2021
TeleflexWeck Efx Shield Port Site Closure System$20
1 payment
  • Meals for Weck Efx Shield Port Site Closure System · 2021-09-16 · $20
Smith+NephewStravix$18
1 payment
  • Meals for Stravix · 2021-05-06 · $18

2020: $21

Payments by company in 2020
Smith+NephewStravix$21
1 payment
  • Meals for Stravix · 2020-08-05 · $21

2019: $89

Payments by company in 2019
Intuitive SurgicalDa Vinci Surgical System$89
1 payment
  • Meals for Da Vinci Surgical System · 2019-04-03 · $89

Professional record

NPI
1982679239
Licence
CA G66787California G66787: Current · expires 2027-09-30
Trained
University of South Florida College of Medicine, 1988
Group
Surgicalists of CA PC · County of Santa Clara
Gender
Male
More record details
Sole proprietor
No
Medicaid ID
NJ 8135703
Taxonomy
Surgery (208600000X)
Mailing address
680 Guzzi Ln Ste 101, Sonora, CA, 95370
NPI first listed
2006-02-21
NPI last updated
2024-03-05
NPI record certified
2024-03-05

This is when the NPI record was last certified, not a medical board exam.